Rescue therapy with rifabutin regimen for refractory Helicobacter pylori infection with dual drug-resistant strains
Abstract Background There is no current standard rescue treatment for dual drug-resistant strains of Helicobacter pylori (H. pylori). This aim of this study was to investigate the efficacy of rifabutin-based triple therapy for patients infected with dual drug-resistant strains to clarithromycin and...
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doaj-b8e29faf3c6b4c5fa4981ca6b21e191c2020-11-25T03:17:08ZengBMCBMC Gastroenterology1471-230X2020-07-012011510.1186/s12876-020-01370-4Rescue therapy with rifabutin regimen for refractory Helicobacter pylori infection with dual drug-resistant strainsChia-Jung Kuo0Cheng-Yu Lin1Puo-Hsien Le2Pi-Yueh Chang3Chih-Ho Lai4Wey-Ran Lin5Ming-Ling Chang6Jun-Te Hsu7Hao-Tsai Cheng8Chi-Nan Tseng9Chun-Jung Lin10Ming-Yao Su11Sen-Yung Hsieh12Cheng-Tang Chiu13Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at LinkouDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at LinkouDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at LinkouChang Gung University, College of MedicineChang Gung University, College of MedicineDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at LinkouDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at LinkouChang Gung University, College of MedicineChang Gung University, College of MedicineDepartment of Cardiothoracic and Vascular Surgery, Chang Gung Memorial HospitalDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at LinkouChang Gung University, College of MedicineDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at LinkouDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at LinkouAbstract Background There is no current standard rescue treatment for dual drug-resistant strains of Helicobacter pylori (H. pylori). This aim of this study was to investigate the efficacy of rifabutin-based triple therapy for patients infected with dual drug-resistant strains to clarithromycin and levofloxacin. Methods After 2 or 3 H. pylori treatment failures, patients underwent upper endoscopy with tissue biopsies. Phenotypic and genotypic resistances were determined using agar dilution test and polymerase chain reaction with direct sequencing, respectively. Patients infected with dual drug-resistant (clarithromycin and levofloxacin) strains and receiving rifabutin-based triple therapy (rifabutin 150 mg bid, amoxicillin 1 g bid and esomeprazole 40 mg bid for 10 days) were enrolled. Eradication status was determined by 13C-urea breath test 4 weeks after treatment completion. Results A total of 39 patients infected with dual drug-resistant strains were enrolled in this study, with a mean age of 55.9 years. The eradication rate was 79.5% (31/39) (95% confidence intervals: 54.96% ~ 111.40%). Adverse event was reported in 23.1% (9/39) of patients but they were mild and tolerable. In univariate analysis, no factor was identified as an independent predictor of eradication failure. Conclusions Our current study demonstrated that rifabutin-based triple therapy was well tolerated and yielded an acceptable eradication rate for patients infected with dual drug-resistant strains of H. pylori.http://link.springer.com/article/10.1186/s12876-020-01370-4 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chia-Jung Kuo Cheng-Yu Lin Puo-Hsien Le Pi-Yueh Chang Chih-Ho Lai Wey-Ran Lin Ming-Ling Chang Jun-Te Hsu Hao-Tsai Cheng Chi-Nan Tseng Chun-Jung Lin Ming-Yao Su Sen-Yung Hsieh Cheng-Tang Chiu |
spellingShingle |
Chia-Jung Kuo Cheng-Yu Lin Puo-Hsien Le Pi-Yueh Chang Chih-Ho Lai Wey-Ran Lin Ming-Ling Chang Jun-Te Hsu Hao-Tsai Cheng Chi-Nan Tseng Chun-Jung Lin Ming-Yao Su Sen-Yung Hsieh Cheng-Tang Chiu Rescue therapy with rifabutin regimen for refractory Helicobacter pylori infection with dual drug-resistant strains BMC Gastroenterology |
author_facet |
Chia-Jung Kuo Cheng-Yu Lin Puo-Hsien Le Pi-Yueh Chang Chih-Ho Lai Wey-Ran Lin Ming-Ling Chang Jun-Te Hsu Hao-Tsai Cheng Chi-Nan Tseng Chun-Jung Lin Ming-Yao Su Sen-Yung Hsieh Cheng-Tang Chiu |
author_sort |
Chia-Jung Kuo |
title |
Rescue therapy with rifabutin regimen for refractory Helicobacter pylori infection with dual drug-resistant strains |
title_short |
Rescue therapy with rifabutin regimen for refractory Helicobacter pylori infection with dual drug-resistant strains |
title_full |
Rescue therapy with rifabutin regimen for refractory Helicobacter pylori infection with dual drug-resistant strains |
title_fullStr |
Rescue therapy with rifabutin regimen for refractory Helicobacter pylori infection with dual drug-resistant strains |
title_full_unstemmed |
Rescue therapy with rifabutin regimen for refractory Helicobacter pylori infection with dual drug-resistant strains |
title_sort |
rescue therapy with rifabutin regimen for refractory helicobacter pylori infection with dual drug-resistant strains |
publisher |
BMC |
series |
BMC Gastroenterology |
issn |
1471-230X |
publishDate |
2020-07-01 |
description |
Abstract Background There is no current standard rescue treatment for dual drug-resistant strains of Helicobacter pylori (H. pylori). This aim of this study was to investigate the efficacy of rifabutin-based triple therapy for patients infected with dual drug-resistant strains to clarithromycin and levofloxacin. Methods After 2 or 3 H. pylori treatment failures, patients underwent upper endoscopy with tissue biopsies. Phenotypic and genotypic resistances were determined using agar dilution test and polymerase chain reaction with direct sequencing, respectively. Patients infected with dual drug-resistant (clarithromycin and levofloxacin) strains and receiving rifabutin-based triple therapy (rifabutin 150 mg bid, amoxicillin 1 g bid and esomeprazole 40 mg bid for 10 days) were enrolled. Eradication status was determined by 13C-urea breath test 4 weeks after treatment completion. Results A total of 39 patients infected with dual drug-resistant strains were enrolled in this study, with a mean age of 55.9 years. The eradication rate was 79.5% (31/39) (95% confidence intervals: 54.96% ~ 111.40%). Adverse event was reported in 23.1% (9/39) of patients but they were mild and tolerable. In univariate analysis, no factor was identified as an independent predictor of eradication failure. Conclusions Our current study demonstrated that rifabutin-based triple therapy was well tolerated and yielded an acceptable eradication rate for patients infected with dual drug-resistant strains of H. pylori. |
url |
http://link.springer.com/article/10.1186/s12876-020-01370-4 |
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